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Individual

AMY DIVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
100 MEDICAL CENTER PKWY STE 100, HUNTSVILLE, TX 77340-4959
(936) 293-8800
Mailing address
13326 ENCHANTED WAY DR, MONTGOMERY, TX 77356-5211
(936) 520-9370

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2157339
TX

Other

Enumeration date
05/05/2021
Last updated
05/05/2021
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